Adult Cold Sore Treatment (Oral Herpes) in California
MD-only cold sore care by secure video in California, $49 flat-fee, no insurance required.
Cold sores are caused by herpes simplex virus, usually HSV-1, and typically appear as tingling followed by clustered blisters on or near the lip. Antiviral treatment works best when started early. Telehealth is appropriate for most adults with a familiar outbreak pattern and for those who want a plan for future outbreaks.
- $49 flat-fee visit
- MD-only evaluation and prescribing
- Same-day antiviral options when appropriate
- Confidential, secure video visits
- Adults only, California-based care
Clinician note: TeleDirectMD care is MD-only and guideline-based. Your visit is reviewed by a physician (Parth Bhavsar, MD). We prescribe antivirals when appropriate, discuss how to reduce outbreaks and prevent transmission, and clarify when in-person evaluation is needed.
Online Oral Herpes Care by California-Licensed MDs
- Typical cold sore assessment and triage
- Oral antiviral therapy when appropriate
- Future outbreak action plans
- Red flags for eye involvement or severe infection
Adults only (18+). You must be physically located in California at the time of your visit. Eye pain, redness, light sensitivity, vision changes, severe facial swelling, high fever, or significant immune compromise require urgent in-person evaluation.
What Are Cold Sores?
Cold sores, also called oral herpes, are caused by herpes simplex virus, most often HSV-1. After initial infection, the virus stays in the body and can reactivate, commonly during stress, illness, sun exposure, or sleep deprivation. Outbreaks usually start with tingling, itching, or burning before blisters appear.
TeleDirectMD focuses on adult evaluation and treatment of typical cold sore outbreaks. During your visit, the MD reviews your symptoms and history to confirm a typical pattern, screens for red flags such as eye involvement, and determines whether antiviral treatment is appropriate.
Symptoms and Red Flags
| Finding | What it suggests | Telehealth appropriate? | Red flag requiring in-person care |
|---|---|---|---|
| Tingling or burning on the lip | Prodrome before blisters | Yes | New severe facial numbness or weakness |
| Clustered blisters on the lip border | Typical cold sore outbreak | Often yes | Extensive sores with high fever or severe swelling |
| Crusting after blisters | Normal healing phase | Yes | Worsening redness, pus, or spreading infection around the lesion |
| Eye irritation, redness, light sensitivity | Possible ocular herpes, urgent | No | Same-day urgent eye evaluation recommended |
What Else Can Look Like a Cold Sore?
- Canker sore: inside the mouth, not on the lip border, not blister clusters.
- Impetigo: honey-colored crusting and spreading skin infection.
- Angular cheilitis: cracking at the corners of the mouth.
- Allergic or irritant dermatitis: widespread irritation rather than grouped blisters.
When a Video Visit Is Appropriate vs. When to Go In-Person
When a Video Visit Is Appropriate
- Adult 18+ with a familiar cold sore pattern
- Symptoms started within the last 48 hours
- No eye symptoms
- No extensive facial swelling or severe illness
- Physically located in California at the time of the video visit
Red Flags Requiring In-Person or Urgent Care
- Eye pain, redness, light sensitivity, or vision changes
- High fever or severe facial swelling
- Rapidly spreading skin redness, pus, or severe worsening pain
- Significant immune compromise
- Uncertain diagnosis or first-ever outbreak with extensive symptoms
Treatment Options for Adult Cold Sores
Antivirals work best when started early, ideally during tingling and burning before blisters fully form. Treatment can shorten outbreak duration and reduce discomfort. Some adults with frequent outbreaks benefit from an action plan or suppressive therapy.
Supportive Care
- Avoid touching the sore and wash hands after any contact.
- Use petroleum jelly to protect the area and reduce cracking.
- Apply cold compresses for 5 to 10 minutes as needed.
- Acetaminophen 650 mg by mouth every 6 hours as needed, maximum 3000 mg per day.
- Ibuprofen 400 mg by mouth every 6 to 8 hours as needed with food if safe for you.
Antiviral Medication Options
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Valacyclovir | 2 g by mouth 2 times daily | 1 day | Early outbreak treatment, start as soon as symptoms begin |
| Acyclovir | 400 mg by mouth 5 times daily | 5 days | Alternative outbreak regimen in selected adults |
| Famciclovir | 1500 mg by mouth 1 time | 1 day | Alternative early outbreak regimen in selected adults |
TeleDirectMD does not prescribe controlled substances. If you have eye symptoms, high fever, severe facial swelling, rapidly spreading skin redness, or significant immune compromise, seek urgent in-person evaluation.
Home Care, Prevention, and Return to Work
Cold sores often heal in 7 to 10 days. Many adults can continue work as tolerated. The biggest prevention steps are early antiviral treatment when appropriate and reducing spread to others.
- Avoid kissing and oral sex during an outbreak and until the skin fully heals.
- Do not share drinks, utensils, lip balm, or towels during an outbreak.
- Consider sunscreen lip balm if sun exposure triggers outbreaks.
- If outbreaks are frequent, discuss a prevention plan during your visit.
What to Expect From Your TeleDirectMD Visit
TeleDirectMD provides adult-only, MD-only virtual urgent care by secure video. Visits typically last about 10 to 15 minutes and cost $49 as a flat cash fee with no insurance involvement. During your visit, the MD reviews symptoms, timing, outbreak history, and red flags.
If your presentation is appropriate for telehealth, we can send an electronic prescription to your preferred local pharmacy in California when appropriate. If you need urgent in-person evaluation, we will explain why and guide you on the safest next step.
We do not prescribe controlled substances.
Cold Sore Treatment FAQ
Can I get cold sore medication online today?
Often, yes. If your symptoms fit a typical cold sore outbreak and there are no red flags, TeleDirectMD can prescribe an antiviral and send it electronically to your local California pharmacy. Antivirals work best when started early.
Is a cold sore the same thing as herpes?
Yes. Cold sores are caused by herpes simplex virus, usually HSV-1. The same virus can sometimes cause genital infection as well.
How quickly do antivirals work?
Many adults notice reduced pain and shorter outbreaks when treatment is started early. Improvement is often noticeable within 1 to 2 days, but full healing still takes time.
When am I contagious?
You are most contagious when blisters and open sores are present, but virus can sometimes shed even without visible sores. Avoid close contact during outbreaks.
Can I prevent future outbreaks?
Many people benefit from identifying triggers such as stress, illness, and sun exposure. Early antiviral treatment can help, and some adults with frequent outbreaks may benefit from a prevention plan.
What if this is my first-ever cold sore?
Telehealth can still be helpful for evaluation, but if the diagnosis is uncertain or symptoms are severe, in-person evaluation may be recommended to rule out other causes.
When should I seek urgent in-person care?
Seek urgent evaluation for eye pain or redness, light sensitivity, vision changes, high fever, severe facial swelling, rapidly spreading redness or pus, or significant immune compromise.
Is TeleDirectMD available throughout California for cold sore care?
Yes. As long as you are physically located in California at the time of your visit, you can use TeleDirectMD for cold sore evaluation and treatment guidance. Prescriptions are sent electronically to your local California pharmacy when appropriate.
Can TeleDirectMD provide a work note?
TeleDirectMD can provide a brief work note when medically appropriate as part of the $49 visit.